CLINICAL AND LABORATORY CHARACTERISTICS OF PATIENTS WHO SUFFERED MYOCARDIAL INFARCTION IN COMBINATION WITH CARBOHYDRATE METABOLISM DISORDERS DURING THE NEW CORONAVIRUS PANDEMIC

Maltsev A. I., Koriagina N. A., Koriagin V. S.

Although acute myocardial infarction (AMI) requires timely intervention, nationwide data on the association between disruption of emergency services and outcomes in patients with AMI during the 2019 novel coronavirus infection (COVID- 19) pandemic are limited. In addition, it has not yet been investigated whether impaired carbohydrate metabolism affects the severity of the disease in these patients. The aim of the study was to determine the clinical and laboratory features of acute myocardial infarction in people with impaired carbohydrate metabolism (ICM) before and during the COVID- 19 pandemic. Results. in 2020, 151 people and 289 in 2019 with AMI applied to the regional vascular center, while in 2019 there were 162 people with ICM and 93 patients with AMI with ICM in 2020. In the average delivery time from pain to doors during the pandemic were significantly larger than before the pandemic (812 (355, 1850) vs. 380 (131, 755) min, p = 0.02). There were 56 (60%) patients in 2020 and 46 (28%) in 2019 among persons with AMI and ICM, who applied 12 hours after the onset of pain in the pandemic and pre-pandemic eras (p = 0.011). In 2020, the proportion of elderly patients and women was higher in the group with ICM than in the group without ICM (p  = 0.002). There is a significant decrease in the indicators of blood purification of the glomerular filtration rate in 2020 with AMI and ICM. Glucose levels in both years were comparable. The marker of myocardial necrosis Troponin I, ng/ml in the 2019 group was 2.659±8.057 (CI 1.405–3.913), and in 2020 it was 6.301±12.728 (CI 3.605–8.998), p=0.016., the significance of differences indicates a greater manifestation of myocardial necrosis in the group of AMI with ICM in 2020 due to late seeking medical help. The time spent in the intensive care unit and the number of days on artificial lung ventilation have significant differences. Conclusions: Conclusions. We observed a decrease in the number of AMI patients admitted to the vascular center during the covid 19 outbreak compared to the previous year. During the outbreak period, there was a significantly longer duration of symptom onset before an emergency room visit, in addition to a higher rate of resuscitation and ventilation. It was AMI patients with impaired glucose metabolism who waited much longer during the pandemic to seek medical help. These results resulted in more than a doubling of the time from pain onset to revascularization, which increases the risk of future complications. This fact significantly influenced the clinical and laboratory indicators of the severity of patients with myocardial infarction against the background of carbohydrate metabolism disorders, even if there were no differences in glycemia levels.

Keywords:SARS-CoV-2; Delayed revascularization; Acute myocardial infarction